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2016 MOD Precsion Line Test
Testing and Inspection Certificate Tanknology Inc. 11000 North MoPac Expressway, Suite 500, Austin, TX 78759 800-800-4633 www.tanknology.com Page 1 of 1 Test Date 7/8/2016 Tanknology WO#SC1-3431819 Test Purpose COMPLIANCE Customer PO# Customer Location WALMART/SAM'S CLUB DEPT. 9641 2101 SE Simple Savings Dr. BENTONVILLE, AR 72716 SAM'S CLUB # 4819 (SC4819) 5625 GOSFORD ROAD BAKERSFIELD, CA 93313 Attn: Roy Garcia Attn: Asset Protection Manager (479) 277-8205 (661) 654-8565 Test / Inspection Description Item Tested Date Tested Result Precision Line Tightness (.1 GPH) Tank DIESEL Line 1 DIESEL2 7/8/2016 Pass Tanknology Representative: JEFFREY KERTIS Technician: Patrick Pfrang Telephone: (800) 964-0010 Technician Certification: (See forms) Product Line Tightness Test Page 1 of 1 Work Order: 3431819 Date: 7/8/2016 Site Name/ID: SAM'S CLUB # 4819 / SC4819 Address: 5625 GOSFORD ROAD City: BAKERSFIELD State: CA Zip: 93313 Tank Information Test Method Customer Tank ID Product Name Delivery Type Test Pressure Test Start Time Test End Time Final Leak Rate Test Result(P/F/I) Test was performed per 3rd party certifications as specified in 40 CFR parts 280 and 281 Tank # 4 Line # 1 TLD-1 DIESEL DIESEL2 Pressure 50 08:06 08:36 0.00 Pass Yes Tank # Line # Tank # Line # Tank # Line # Tank # Line # Tank # Line # Technician Comments: Diesel line test pass. Tested from dispenser 7/8 do to repair made at piping sump for diesel. Technician Name:Patrick Pfrang Certification #:44642 exp: 4/9/2019 Technician Signature: Environmental Compliance for Petroleum Systems ©2016 Tanknology Inc., Austin, TX. All rights reserved. tanknology.com Site Diagram (This site diagram is for reference only and is not drawn to scale) Work Order:3431819 Site ID / Name:SC4819 / SAM'S CLUB # 4819 Address:5625 GOSFORD ROAD City:BAKERSFIELD State:CA Zip:93313